Anxiety Disorder Due to a General Medical condition

Many medical conditions may result in symptoms of anxiety, and the consultant should consider this possibility if the history is not typical for a primary anxiety disorder or if anxiety symptoms are resistant to treatment (see Table 7-5). Medical etiologies are also more likely when physical symptoms of anxiety, such as shortness of breath, tachycardia, or tremor, are more marked. Anxiety that is secondary to a medical condition should be differentiated from co-morbid anxiety or anxiety that is a reaction to the underlying medical illness. Table 7-6 lists some of the more common medical conditions that may result in symptoms of anxiety.

With respect to anxiety disorders due to medical conditions, the mental health consultant needs to appreciate that all patients facing a physical illness and its treatment will experience noncategorical effects of anxiety. From this perspective, children and their families are seen as experiencing stress as a result of being ill and not because of specific factors associated with a particular disease. For example, invasive medical procedures (e.g., venipunctures, in travenous lines) are common across illness types and can cause anxiety. Rather than being related to a specific physical illness, these anxiety symptoms are more related to the child's premorbid anxiety vulnerability, developmental stage, family functioning, and degree of psychosocial stress in the environment. In the following subsections, we provide brief overviews of some of the more frequently encountered specific general medical conditions associated with physiological symptoms of anxiety.